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Encephalopathy after furosemide use in nephrotic syndrome


Dr Ajay P Sharma, Pediatric Nephrology, 800, Commissioner’s Road E, Children’s Hospital of Western Ontario/London Health Sciences Centre, London, ON, Canada N6A 2V5. Fax: 519-685-8156; email:


Abstract:  An 18-year-old girl with nephrotic syndrome presented with a life-threatening respiratory failure and a severe encephalopathy, shortly after being started on furosemide. The evaluation confirmed furosemide as the sole culprit for the clinical manifestations. This case highlights an unpredictable dose–response relationship of furosemide. The pathophysiological basis, differential diagnosis and clinical implications of the observed findings are discussed.